About a year ago, when Microsoft announced Windows 8, I predicted
that Windows 8 and the new ecosystem of mobile tablet PCs would enable
clinicians to overcome the HIT
productivity paradox.Over the past several
months we've been receiving a steady stream of customer feedback from front
line physicians telling us that they are in fact, defying the HIT productivity
paradox by running their EHRs on Windows 8 and Surface Pro, together, and
finding that they're not only able to restore their pre-EHR productivity
levels, but actually surpass them.One
of those recent reports came from Palmetto Health, based in Columbia, SC, the
largest Cerner ambulatory EHR deployment, covering 60 practices.

A few months ago, several Palmetto Health doctors bought Surface
Pro tablets for themselves at a local Best Buy retail store, brought them in to
work with them, and found that they could run their fully functional EHR in
virtualization mode with all the inputs they needed to be maximally productive:
pen, voice, touch, keyboard, and mouse. As a result, these docs reported
that they're seeing at least 2-3 more patients per day, spending more time with
patients, going home on time, and improved their CGCAHPS scores (Clinician and
Group Consumer Assessment of Healthcare Providers and Systems).Watch this video footage that captures their
experiences in their own words:Doctors prescribe
Surface Pro to improve patient care.

When I heard about this amazing story, I decided I had to make the
trip to Columbia to witness firsthand the productivity gains they were
reporting, and dig deeper into what exactly they were doing right that other
clinical practices weren't.I wanted to
understand how these physicians were using Surface Pro and Windows 8 to
overcome some of the EHR productivity killers that were frustrating so many
other physicians.,I also wanted clarity
on what was it about the Surface Pro that enabled them to improve their
productivity and improve patient satisfaction so dramatically.

Here's what I found out when I arrived.The post-EHR implementation problem they had
to solve was a common one: Making patient record access and documentation with
their EHR as easy as it was with the paper charts they carried with them
before, during and after they entered the patient room.Previously they could pick up the paper chart
before they entered the room, quickly scan it to review the history and
understand the purpose of the visit before they entered the room.The instant they entered the room, they could
immediately start a contextually relevant conversation and start taking notes
before they even sat down.However, once
they implemented their EHR, they couldn't access their EHR until they were in
the room and logged into one of the multi-user workstation that were installed
in each exam room--which meant that they had to wait until they sat down and
logged into the multi-user workstation to get their first glimpse at the
patient's chart.In order to scan the
EHR before entering the room—like they were able to with their paper charts--some
physicians would go back to their private office and log into their workstation
between visits.Further, if they could not
complete their documentation while the patient was still in the room, they had
to log off of the workstation, discharge the patient, and delay the completion
of their charting to a later time, which was more often than not, after the
clinic closed, which meant getting home later.According to the physicians, this amounted to roughly a loss of at 1.5-3
minutes of productivity per patient, which added up to 30-60 minutes
productivity lost per 20 patient day.

Like many, they turned to iPad as a way to reclaim
lost productivity before, during and after the patient visit and maintain
better eye contact with patients during the visit.The results were disappointing.When they attempted to run their EHR in
virtualization mode on the iPad, their experience mirrored
what most of their colleagues experienced:iPads work well
for accessing information and media but fell far short in the full
functionality they needed to replace the multi-user workstations.According to Dr Nick Patel, a self-confessed
Apple fan, "...the problem with the iPadwas that it didn't have the horsepower to run
the complexity of our EHR.You also have
to go to a remote sign-on which was extremely slow."

After spending an entire day with the Palmetto Health care team,
it became clear to me that by doing five things right with their Surface Pro,
their primary care physicians were able to not only reclaim the productivity
lost to their EHR implementation, but actually exceed their pre-EHR
productivity levels.

Do you know any primary care clinics that have increased their
productivity and patient satisfaction above and beyond their pre-EHR
implementation baseline?If so, what did
they do right?

Stay tuned for the Part 3 of this series coming next week! If you
have a comment or opinion on this post or a question for the author? Send us an
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